Some of you may know that I am a Type 2 Diabetic. I did my first challenging hike since being diagnosed with his insidious disease and I did pretty well but would like to hear form others that are afflicted with this as to how they manage on the trail. Food, eating regiment, hydration etc. In tips and pointers would be greatly appreciated. I feel that the more we talk about this the more enjoyable the backcountry will be!

Yeah, I have type 2. When I am out hiking, my sugar is fine. I usually require two pills a day, instead, I only take one. If I am really working, sometimes I skip the one. Exercise will greatly diminish the effects of type 2. I get some every day. Out hiking, I am using those old muscels to keep my sugar down. 120 or 130 is a good reading. It started about 10 years ago. For the first couple years I brought all the testing tools with me and watched it like a hawk. About two years ago I did the same, but didn't notice any great difference in my conclusion. Work, tired muscels burn any extra off quickly. If it gets a bit low, I eat a handfull of sugar (some sort of candy.) But, I can tell when it is getting low, no meter needed.

I still check mine frequently even though I haven't taken any medications for this since May 2011. I test six to eight times a day usually - sometimes 9 or 10. My biggest problem now is that I have a hard time getting it above 5.3 mmol/L (94 mg/dL) even after I eat. Why is that an issue? Well it means I go low easily with activity. It's frustrating. So on most trips I struggle with lows and balance. I find I basically have to eat like everyone who isn't diabetic in our group and that I don't have to worry as much about the carb intake. And... I graze. Little bits throughout the day punctuated by our meals. I tend to eat like this... breakfast... snack... lunch... snack... dinner... snack. Repeat. Sometimes, I have to add in another snack if I go low. I carry Dex4 at all times. Just in case. I wear a medic-alert bracelet and leave copies of my itinerary with family and the rangers. Overkill? Maybe.

I think I've only had two instances in the last year where it was above 7.2 mmol/L (129 mg/dL). One was during the TREAD running relay in the steep hills and I overcompensated between my laps. I was 9.2 mmol/L (165 mg/dL) going into my second lap and I had about 24 g of carb knowing that the intensity was high. By the time I reached the finish line I was below my pre-meal levels. The second time was when I had an allergic reaction and was put on Prednisone. It sent my numbers haywire.

My basic advice... while you are on medication keep a close eye on your numbers and find out what works for you. You might even find with increases in day-to-day activity outside of hiking, that you could even get to a point where you don't need medications. Each one of us is so different when it comes to what works and what doesn't but all physical activity will help a T2 become more insulin sensitive, if only temporarily. That's why it is such an important key in treatment/control.

Staying well hydrated is crucial. Dehydration can effect your numbers in a bad way.... it can raise them quite significantly. Add to that the frequent urination that is a symptom of diabetes and it can be a recipe for trouble. If you become severely dehydrated you put yourself at risk of ketoacidosis. Not a good thing. It put me in the hospital in April 2009 (I had the flu).

I take my insulin gear when I backpack, which is a blood glucose tester, a small notebook, a syringe of fast acting insulin, and a syringe of slow acting insulin. After a day or so, I use much less insulin than I do in town. After 2 days, I don't use any insulin at all. I think hard muscle work helps sugar get into cells on its own, or stimulates the body's natural insulin making cells.

The biggest danger to me is taking too much insulin, and waking at night hungry and shaky. I keep a granola bar handy at night for that reason.